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Biomedical subjects

F Schillinger

Publications and source records attributed to F Schillinger.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Recombinant human erythropoietin (epoetin) and autologous blood transfusion in chronic hemodialysis. Apropos of 2 cases].

Recombinant human erythropoietin (epoetin) is sometimes used in order to enhance autologous blood predonation before scheduled hemorrhagic surgery. This procedure reduces and some times better avoids homologous blood transfusions with their disadvantages. In certain circumstances, it will be of particular importance and, despite of its cost, has to be discussed for several surgical operations in some patients. Among them, pre-dialysis and dialysis patients can benefit of autologous blood transfusion if their anemic state and the response to epoetin and iron supplementation allow a sufficient and well-tolerated preoperative collection. As such observations are rare, we report two successful cases of autologous transfusion strategy with epoetin therapy in chronic hemodialyzed patients undergoing orthopedic surgery.

Aged↗
PubMed1997

[Bilateral nephrectomy before renal transplantation in autosomal dominant polycystic renal disease].

Patients with autosomal dominant polycystic kidney disease are good candidates for renal transplantation, despite the fact that they are older at initiation of dialysis treatment. After grafting, the native polycystic kidneys are, however, at risk of infectious and hemorrhagic complications, in addition to patient's discomfort and technical difficulties with graft placement. We report on 10 successful cases of pretransplant binephrectomy performed in one time and analyse the risk factors of such a surgery. Nowadays, it appears that the disadvantages of an anephric state can be balanced by substitutive therapy. In conclusion, after this short series, we think that bilateral nephrectomy has to be considered in patients with autosomal polycystic kidney disease, especially when they have a prior history of renal infections and/or repeated hematurias.

Adult↗
PubMed1996

[Auto-dialysis: an 11-year experience of a hemodialysis center in France].

OBJECTIVES: Report 11 years of experience with self-managed hemodialysis in patients medically apt for extra-hospital dialysis and living close enough to small outpatient hemodialysis units to become totally self-sufficient. RESULTS: Among the 276 patients with chronic renal failure managed at the hemodialysis center at the Troyes hospital during the 11-year study period from 1984 through 1994, self-managed hemodialysis at small outpatient units was initiated in 127 (46%). None of these 127 patients required medical assistance or specific care during dialysis sessions. At initial hospital admission, only 60/127 (47%) were totally self-sufficient: 52 (41%) were later graft recipients; and 21 (16.5%) had to return to the hospital for a medical or surgical condition incompatible with extra-hospital care but all of these 21 patients remained self-sufficient. CONCLUSION: Extra-hospital hemodialysis in units close to the patients residence offers patients a better quality of life, even when medical assistance is required. All patients who require hemodialysis can thus be treated at lower cost without compromising quality of treatment. Perfect self-sufficiency may not be a goal in itself, but self-managed hemodialysis can be a very useful technique for patients without major medical problems. Continuing contact with the organizing hemodialysis center guarantees the safety of the system.

Adolescent↗
PubMed1996

Isochromosome i(3q) and premature chromosome condensation are recurrent findings in chronic B-cell lymphocytosis with binucleated lymphocytes.

Chronic B lymphocytosis with binucleated lymphocytes (LWBL) is a recently described entity. The lymphocytosis is stable over years and atypical binucleated lymphocytes are detected on peripheral blood smears. Further investigation has shown a predominance in females, a polyclonal increase in serum IgM and HLA-DR7 expression in most cases. In almost all cases cytogenetic studies with classical culture conditions have not shown any abnormality. We describe 7 patients with LWBL associated with an abnormal karyotype. An additional i(3q) was found in 6 cases. Premature chromosome condensation (PCC) was detected in all 7 cases. As both abnormalities are rarely present in other benign or malignant proliferations, we suggest a strong correlation between LWBL and i(3q) and/or PCC.

Adult↗
PubMed1996

Chronic renal failure and its treatment in tuberous sclerosis.

BACKGROUND: Chronic renal failure is rare in tuberous sclerosis, but its precise frequency is not known and treatment modalities have not been evaluated. METHODS: A questionnaire was addressed to the 260 French dialysis centres and the characteristics of 65 patients with tuberous sclerosis and chronic renal failure were analysed. RESULTS: In France the approximate prevalence of tuberous sclerosis with end-stage renal failure is 0.7 cases per million and that of end-stage renal failure in tuberous sclerosis 1 per 100. Tuberous sclerosis with chronic renal failure was more frequent in females (63.1%) and was diagnosed at a mean age of 29 years. Renal impairment was the first manifestation of tuberous sclerosis in about half the cases. Renal tumours were frequent, with angiomyolipomas in 15 cases (23.1%), cysts in 12 cases (18.5%), and both in 35 cases (53.8%). Malignancies were associated in nine cases (13.8%). Nephrectomy was done before dialysis in 21 cases (32.3%), and after the start of dialysis in six cases (9.2%). All but one of the 48 patients with end-stage renal failure were treated by dialysis; 20 were transplanted, with good results. CONCLUSIONS: Tuberous sclerosis with end-stage renal failure is rare. These patients require dialysis and renal transplantation, but we recommend binephrectomy after starting dialysis and before transplantation, given the risk of cancer and bleeding related to angiomyolipomas.

Adult↗
PubMed1996

[Femoral indwelling silicone catheter: experience of three hemodialysis centers].

The use of femoral vein for temporary access in hemodialysis patients is still considered as a slightly desirable route. However recent technical improvements have made this approach more reliable because the new femoral catheters can be left in place for a long time and used for ambulatory treatment. We describe the experience of three hemodialysis centres with temporary indwelling femoral catheter made of silicone (SSL 1220 M, Medcomp) in 55 patients: 3 patients with acute renal failure, 1 requiring plasmapheresis and 51 with chronic renal failure but no other available vascular access. Sixty four catheters were implanted and left in place for a mean of 41.5 +/- 30 days. Complications (mechanical, thrombotic and infectious) were infrequent and never life-threatening. These results suggest that the femoral route can be used reliably for temporary access, and provides advantages over subclavian and jugular routes in certain circumstances.

Acute Kidney Injury↗
PubMed1995

[Repeated studies of the prevalence of Staphylococcus aureus in the nasal cavity in hemodialysed patients].

OBJECTIVES: In order to better establish a prevention strategy based on mupirocin, we evaluated nasal carriage of Staphylococcus aureus in haemodialysis patients over a 15 month period. METHODS: Search for Staphylococcus aureus in the nasal cavities was made every 2 months in 92 chronic dialysis patients. These patients were divided into 3 groups according to the nature of the carriage: non-permanent, intermittent or permanent. RESULTS: Among the 80 patients retained for analysis, there were 27.5% with intermittent carriage and 11.25% with permanent carriage. Factors which appeared to protect against carriage were rural residence and home self-dialysis. CONCLUSION: Repeated long-term search for nasal carriage of Staphylococcus aureus has provided reliable data for each patient and gave information on the effects of epidemiological conditions and health care structures.

Aged↗
PubMed1995

Heterogeneity of t(1;19)(q23;p13) acute leukaemias. French Haematological Cytology Group.

The t(1;19)(q23;p13) translocation occurs commonly in B-lineage ALL. Previous reports have demonstrated a predominance of cases with expression of cytoplasmic Ig mu (C mu+), and FAB L1/L2 phenotype, a poor prognosis and expression of a fusion transcript involving the E2A and PBX1 genes in C mu+ but not in C mu- cases. Of 38 patients with karyotypically proven t(1;19) (q23;p13) leukaemias, we extensively analysed 18 patients with acute leukaemia including 16 B-lineage ALLs, one T-ALL and one AML M4. The AML was associated with a classic E2A-PBX1 fusion transcript and may represent the human counterpart of the AMLs induced by E2A-PBX1 retroviral infection of murine marrow progenitors. The T-ALL was E2A-PBX1 negative and neither the E2A nor the LYL-1 genes, both situated at chromosome 19 p13, were rearranged. Of the 16 B-lineage ALLs, four had cytological features resembling an 'L3-like' phenotype classically associated with Burkitt's lymphoma, two at diagnosis and relapse and two exclusively at relapse. E2A-PBX1 fusion transcripts were detected by RT-PCR in all 13 C mu+ patients and in 2/3 C mu- cases. The 'L3-like' phenotype did not correlate with a particular stage of maturation arrest (one sIg+, one C mu+, one C mu-) or type of E2A-PBX1 transcript, but was associated in all cases with a trisomy 8. Translocation, rearrangement, amplification or over-expression of the c-myc gene was not observed in these cases, demonstrating that the apparent association with trisomy 8 is not due to deregulation of this gene. We therefore show that the E2A-PBX1 transcript, although occurring predominantly in C mu+ pre-B ALL, also occurs in C mu- early pre-B ALL, sIg+ B-ALL and even in AML. These results suggest that the stage of maturation arrest, and indirectly the prognosis, are not solely due to the type of fusion transcript associated with the t(1;19).

Acute Disease↗
PubMed1994

Persistent polyclonal lymphocytosis with binucleated B lymphocytes: a genetic predisposition.

Persistent lymphocytosis is usually associated with a malignant lymphoproliferative disease (MLPD). We report six female patients presenting a chronic, moderate lymphocytosis of 2-16 years duration with atypical binucleated lymphocytes on peripheral blood smears. Further investigation showed a polyclonal increase in serum IgM and HLA-DR7 phenotype in all patients. The B cells were polyclonal because Southern hybridization of DNA and polymerase chain reaction failed to demonstrate a clonal rearrangement of immunoglobulin heavy chain genes. Peripheral blood examination showed binucleated lymphocytes in a family member of two of the cases; taken together with the association with HLA-DR7 these data suggest a genetic predisposition. The identification of this benign syndrome is important in order to prevent its misdiagnosis as a MLPD.

Adult↗